Introduction

The rate of venous thromboembolic events (VTE) after open (ORP) or minimally invasive radical prostatectomy (MIRP) for prostate cancer (PCa) might be decreasing over the last decade. The aim of the present study was to assess the 30- and 90-day VTE rates and mortality over time.

Methods

Using the Surveillance Epidemiology and End results (SEER)- Medicare database, we identified 35104 nonmetastatic PCa patients who underwent RP between 1994 and 2009. The annual incidence rates of VTE and mortality were analyzed over the observation period. The estimated annual percentage change (EAPC) was calculated using the least squares log linear regression method. Based on stepwise selection, risk factors for VTE were identified. Multivariable logistic regression models were performed to test the effect of these variables on VTE rates.

Results

At 30 days after RP, 931 (2.7%) VTE and 87 (0.25%) deaths were recorded. Additionally, at 90-days, 1112 (3.2%) VTE and 121 (0.3%) deaths were registered. Over a period of 15 years, annual 30-day VTE and mortality rates decreased from 3.5% to 2.2% and from 0.4% to 0.2%, respectively. Similarly, 90-day VTE and mortality rates decreased from 4.2% to 2.7% and from 0.6% to 0.3%. Independent VTE-risk factors consisted of older age, longer hospital stay, pelvic lymph node dissection (PLND) and blood transfusions. In multivariable analysis, prostatectomy type (ORP or MIRP) did not affect VTE or mortality rates.

Conclusions

Although, VTE are rare complications, they may result in patient demise. In consequence, patients with one or multiple risk factors should be targeted with preventive strategies.

Funding

none